No office rate
19301 reports the partial mastectomy itself. Use 19294 as an add-on when the tumor cavity is prepared and an applicator is placed for intraoperative radiation.
On this page
CMS RVU26D · Effective 2026-10-01
19294 IORT cavity prep Medicare reimbursement rates in Iowa
Reports preparation of a breast tumor cavity and placement of an intraoperative radiation applicator following partial mastectomy. Compare 19294 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 19294 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$130.56
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Breast surgery
About 19294: Tumor cavity preparation for breast IORT
Reports preparation of a breast tumor cavity and placement of an intraoperative radiation applicator following partial mastectomy.
During breast-conserving surgery, the surgeon prepares the excision cavity and positions an applicator so radiation can be delivered intraoperatively. The service is performed in the operating room after removal of the breast lesion; the applicator is placed in the resulting tumor bed for the planned intraoperative treatment. Radiation delivery itself is a distinct service, commonly performed by a radiation oncologist with the surgical team present.
Report 19294 as an add-on with the primary partial mastectomy procedure, not as a stand-alone service. The operative report should support the partial mastectomy, preparation of the cavity, and placement of the applicator for intraoperative radiation. CMS treats this as an add-on paid within the primary procedure’s global period. The code represents cavity preparation and applicator placement, not the radiation dose or delivery.
CMS billing rules for 19294
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU2.93 · 66%
- Practice expense (office) RVU0.74 · 17%
- Malpractice RVU0.76 · 17%
263
Medicare services in 2024 · #4093 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
19294 compared with similar codes
Office rates for Iowa, from the same CMS release.
$3,648.45
19296 concerns breast catheter placement for a radiation approach using a catheter after partial mastectomy; 19294 is for an applicator placed for treatment during surgery.
No office rate
19297 also concerns breast catheter placement for radiation after partial mastectomy. It is not the cavity-preparation and intraoperative-applicator service described by 19294.
77424
No office rateIo rad tx delivery by x-ray
77424 represents electron intraoperative radiation delivery. 19294 reports the surgical preparation and applicator placement, not the radiation treatment.
Compare 19294 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
Unavailable
Facility
$130.56
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 19294 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
1,681
- Code
- 19294
- Physician work
- 2.93
- Practice expense
- 0.74
- Malpractice
- 0.76
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.93 | × 1.000 | 2.9300 |
| Practice expense | 0.74 | × 0.915 | 0.6771 |
| Malpractice | 0.76 | × 0.397 | 0.3017 |
| Total RVUs | 3.9088 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$130.56
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.93 | 1 |
| Practice expense | 0.74 | 0.915 |
| Malpractice | 0.76 | 0.397 |
(2.93 × 1 + 0.74 × 0.915 + 0.76 × 0.397) × $33.4009 = $130.56
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
19294 billing questions
Can 19294 be reported by itself?
No. It is an add-on code and must be billed with an eligible primary procedure, typically the partial mastectomy.
How does 19294 differ from 19301?
19301 reports the partial mastectomy. 19294 reports the additional work of preparing the tumor cavity and placing the applicator for intraoperative radiation.
Does 19294 include radiation delivery?
No. It covers cavity preparation and applicator placement; radiation delivery is a distinct service, such as the treatment represented by 77424 or 77425.
What documentation supports 19294?
The operative report should describe the partial mastectomy, preparation of the tumor bed, and placement of the applicator for intraoperative radiation.
How does the global-period rule affect reporting?
CMS pays this add-on within the primary procedure’s global period. It must be reported with the primary procedure rather than as a separate stand-alone service.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,67819286,,Perq dev breast add us imag,A,,0.83,7.66,,0.16,,0.09,8.58,1.08,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,67919287,,Perq dev breast 1st mr guide,A,,2.49,15.22,,0.45,,0.23,17.94,3.17,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68019288,,Perq dev breast add mr guide,A,,1.25,12.31,,0.23,,0.12,13.68,1.60,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68119294,,Prepj tum cav iort prtl mast,A,,2.93,0.74,NA,0.74,,0.76,4.43,4.43,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68219296,,Place po breast cath for rad,A,,3.54,115.12,,1.36,,0.90,119.56,5.80,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68319297,,Place breast cath for rad,A,,1.68,0.40,NA,0.40,,0.41,2.49,2.49,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,68419298,,Place breast rad tube/caths,A,,5.61,19.44,,1.84,,0.44,25.49,7.89,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136